Provider Demographics
NPI:1518993104
Name:SOUTHEAST OHIO EMERGENCY MEDICAL SERVICES DISTRICT
Entity Type:Organization
Organization Name:SOUTHEAST OHIO EMERGENCY MEDICAL SERVICES DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:A
Authorized Official - Last Name:KUHN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:740-446-9840
Mailing Address - Street 1:PO BOX 527
Mailing Address - Street 2:
Mailing Address - City:KERR
Mailing Address - State:OH
Mailing Address - Zip Code:45643-0527
Mailing Address - Country:US
Mailing Address - Phone:740-446-9840
Mailing Address - Fax:740-446-6315
Practice Address - Street 1:3240 STATE ROUTE 160
Practice Address - Street 2:
Practice Address - City:GALLIPOLIS
Practice Address - State:OH
Practice Address - Zip Code:45631-9681
Practice Address - Country:US
Practice Address - Phone:740-446-9840
Practice Address - Fax:740-446-6315
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-24
Last Update Date:2008-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH3416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0217376Medicaid
OH9280491Medicare ID - Type Unspecified